Stress and coping styles in Japanese nursing students

Nursing students' use of products and substances to reduce stress or improve cognition during exam periods

AIM

The aim of the project was to evaluate the prevalence, motivation and effects of the use of substances to improve cognitive function by nursing students during examination.

BACKGROUND

Exam periods are among the most stressful weeks of the academic year for nursing students. During these times, some students may use substances to support cognitive functions. Some of them are used despite their potential harmfulness, even by nursing students.

DESIGN

This was a cross-sectional study.

METHODS

The study was based on a voluntary, anonymous survey including 26 questions about use of various products belonging to food, dietary supplements, drugs, alcohol and tobacco. The study population was 221 students of nursing studying at Medical University of Warsaw.

RESULTS

During the exam session, the most frequently used substance was strong tea. Dietary supplements are less popular. The surveyed students rarely use procognitive prescription drugs. However, consumption of alcohol, cigarettes or marijuana during the session was lower than outside of it declared by 61.5 %, 28.5 % and 6.3 % respectively (while outside of the exam session, 80.1 %, 29.0 % and 11.8 %, respectively). As for the purpose of using, most students mention improving concentration and memory, but most are not sure whether the products they use help them achieve their goals. Nearly two-thirds of students are aware of the harmfulness of stimulants and therefore do not use them and the products they do use are relatively safe for health.

CONCLUSIONS

Most nursing students probably are aware of the harmfulness of listed products, especially belonging to prescription drugs, alcohol and stimulants and therefore do not use them. In turn, the products they use, such as chocolate or certain dietary supplements, are relatively safe for health, i.e. they do not cause dangerous addiction or side effects that may require seeking medical help. However, it is worrying that most of them regularly drink alcohol, many of them smoke tobacco and also use marijuana. The results do not indicate that a medical university and nursing vocational schools effectively promotes a healthy lifestyle for nursing students and changes in education in this area are necessary. A wide discussion on how to improve the health habits of future nurses should be taken.

Positive and negative aspects of psychological stress in clinical education in nursing: A scoping review

BACKGROUND

Even though clinical practice is crucial for nursing students' personal and professional development, it is recurrently associated with stress. However, stressful situations may not only elicit negative responses, but positive responses as well, and such aspects should be further investigated.

AIM

To explore the literature addressing the positive and negative aspects of stress experienced by nursing students during clinical practicum.

DESIGN

This scoping review followed the Joanna Briggs Institute (JBI) and PRISMA-ScR guidelines.

DATA SOURCES

CINAHL, MEDLINE/PubMed, PsycINFO, Web of Science, IBECS, LILACS, BDENF and two theses and dissertations repositories.

REVIEW METHODS

Searches were conducted from June to August 2022. Studies addressing the positive and negative aspects of stress experienced by nursing students during clinical practice were included regardless of the method adopted.

RESULTS

This review included 32 studies published between 1999 and 2022 in 25 countries across four continents: Africa, America, Asia, and Europe. Stress can positively influence academic performance, especially in mobilizing a search for learning and professional development and in integrating theoretical knowledge and improving clinical skills and competencies. Negatively, stress can cause biopsychosocial symptoms that compromise a student's academic performance and can cause doubts and uncertainties about the construction of their professional identity.

CONCLUSIONS

Although the negative aspects stand out over the positive ones, it is evident that both are present in the clinical practice environment. When considering stress of nursing students, educators should conduct the teaching-learning process in order to reduce the negative impact and promote the positive side of stressful situations.

Comparison of the psychological health of students at the higher institutes of nursing and health techniques: A Moroccan multicentre study

BACKGROUND

Mental health is essential to students' academic success as well as their ability to participate fully and meaningfully throughout all aspects of their lives and throughout their lifespan.

AIMS

This study aims to determine the psychological health status of Moroccan nursing and technique health students. In doing so, it also seeks to compare differences based on sociodemographic factors.

METHOD

A multicenter cross-sectional study with a convenience sample was conducted with 2,054 participants in the academic year of 2018/2019. A set of socio-demographic information were collected, and The General Health Questionnaire-12 (GHQ-12) was used.

RESULTS

The mean GHQ-12 score was 4.33 ± 2.61, and 58.7% respondents scored 4 and above in the GHQ-12 scores and thus were considered to be in psychological distress. Students' psychological distress was associated with female gender (60.4% for female compared to 52.4% for men, p = .003); living in parental residence (61.6% compared to 54.7% living away parental residence; p = .02 ), the second and the third training level year respectively (64.6%; 59.2%) compared to first-year (55.2%, p = .001), and midwifery and nursing students (61.6%; 60.3%) as compared to technique health students (43.6%, p = .001).

CONCLUSIONS

It appears that a substantial number of students have psychological distress and this is likely to have negative effects on students' educational attainment and wider wellbeing.

Factors associated with mental health among undergraduate nursing students early in the COVID-19 pandemic: an integrative review

OBJECTIVES

We aimed to synthesize research findings identifying factors associated with mental health in undergraduate nursing students early in the COVID-19 pandemic.

METHODS

Seven electronic databases were searched using key terms and subject headings. JBI Critical Appraisal Checklists were used to evaluate research report quality.

RESULTS

Among 23 reports (19 quantitative and four qualitative) meeting inclusion criteria, negative emotional responses to COVID-19 (fear of infection, perceived risk, uncertainty about care/future), negative behavioral responses to COVID-19 (eating behaviors, problematic internet use, insomnia), and negative coping strategies were associated with more adverse mental health symptoms. Conversely, social support, professional identity, preventive behaviors, sufficient personal protective equipment (PPE), and positive coping strategies were related to fewer symptoms.

CONCLUSIONS

During a pandemic, undergraduate nursing students require educational support to promote their ability to avoid severe mental health disorders. Also, educators should strengthen students' professional identity, provide infection prevention knowledge and skills, and supply sufficient PPE.

Seroprevalence of COVID-19 and Psychological Distress among Front Liners at the Universiti Malaysia Sabah Campus during the Third Wave of COVID-19

In 2020, the COVID-19 pandemic struck the globe and disrupted various aspects of psychological wellbeing, more so in frontline workers. Research on assessing the seroprevalence of COVID-19 has been scarce; in addition, there are limited studies assessing the association between the seroprevalence of COVID-19 and psychological distress. Therefore, this study aimed to determine the seroprevalence of COVID-19 and the prevalence of psychological distress and to determine whether sociodemographic variables, occupational information variables, coping styles, and psychological processes might contribute to the development of psychological distress. A cross-sectional study involving 168 Universiti Malaysia Sabah (UMS) front liners was carried out to assess these issues. The Depression, Anxiety and Stress Scale (DASS-21) was employed to assess psychological distress, together with the COVID-19 Rapid Test Kit Antibody (RTK Ab) and a series of questionnaires, including a sociodemographic and occupational information questionnaire, the Balanced Index of Psychological Mindedness (BIPM) questionnaire, the Mindfulness Attention and Awareness Scale (MAAS), the Acceptance and Action Questionnaire (AAQ-II), and the Brief COPE questionnaire. The results demonstrated a seroprevalence of COVID-19 at 8.3% (95% CI = 5.0–14.0). Non-healthcare workers (HCWs) had a higher COVID-19 prevalence. Meanwhile, the prevalence of depression, anxiety, and stress among front liners was low (3.0%, 3.6%, and 1.2%, respectively). Younger people (aged 30 years old or less) and HCWs had a higher prevalence of psychological distress; being a HCW was significantly associated with a higher level of anxiety. Dysfunctional coping and psychological inflexibility were consistently found to be predictors for higher levels of the three psychological distress variables. This study suggested some alternatives that could be explored by mental health providers to address mental health issues among front liners at universities.

Coping strategies of healthcare professional students for stress incurred during their studies: a literature review

BACKGROUND

Stress in healthcare professional students is well-documented, however coping strategies and their relationship with stress has not been comprehensively reviewed. It is necessary for students to use positive coping strategies to effectively reduce stress levels.

AIMS

The aim of this review is to identify coping strategies of healthcare professional students and their consequences.

METHODS

Studies conducted from 2010 to 2020 on coping strategies utilised by healthcare students were reviewed. An electronic database search was performed in January 2020 of three databases CINAHL, SCOPUS and PubMed.

RESULTS

Twenty-two studies were included in this review, using a wide range of survey instruments including the Brief Coping Orientation to Problems Experienced (Brief COPE) Inventory and the Coping Behaviour Inventory Common coping strategies utilised by healthcare students include problem-focused strategies such as planning, problem-solving and active coping. Coping strategies tended to vary depending on student's location, year of their course, gender and age. Positive coping strategies, such as problem-focused strategies, were associated with reduced stress levels and improved psychological health. Other emotion-focused coping strategies identified included acceptance, self-distraction, and optimism.

CONCLUSIONS

Findings may provide direction for third-level institutions in designing interventions (such as encouraging exercise) promoting the use of positive coping strategies.

Differences in Menstruation-Related Symptoms of University Students Depending on Their Living Status in Japan

Mothers and family members of young female students play important roles for guiding their self-care strategies for menstruation-related symptoms; which often affect their daily life and academic life. The aim of this study is to clarify the differences in menstruation-related symptoms before and during menstruation in university students living alone and university students living with their family in Japan. We conducted a cross-sectional online survey to assess menstruation-related symptoms before and during menstruation using the menstrual distress questionnaire (MDQ). Among 135 students; the proportion of students living alone was 60.7% and the proportion of students living with their family was 39.3%. Before menstruation; the MDQ total score and the scores for negative affect and behavior change were significantly higher in students living alone than in students living with their family. During menstruation; scores for negative affect and impaired concentration were also significantly higher in students living alone. In addition; before menstruation; scores for an increase in appetite and craving for sweets were significantly higher in students living alone. Thus; living alone affected the psychological aspects of menstruation-related symptoms in young women. The results suggest that university students who live alone should be aware of the importance of talking about their menstruation problems with family members and seeking their advice

Understanding the support needs of Australian nursing students during COVID-19: a cross-sectional study

Background: COVID-19 has caused significant disruption. This has been particularly evident within the university student population where their traditional ways of learning were abruptly reorganised and support structures removed.Objective: This paper aims to explore undergraduate student nurses' perceptions of the support required from the university during COVID-19 using the Achievement Goal Theory framework.Design: Data were collected via an online survey of undergraduate student nurses from an Australian university. This paper is reporting the data from a single open-ended item asking participants about their support needs from the University. Data were analysed using thematic analysis.Results: Of the 178 students who responded 206 individual statements were provided about the support they would like from the university. Four primary themes emerged, Support beyond academia, Academic support, Online learning readiness and Clinical practice units and clinical placement. The students identified that their needs during this pandemic include financial needs, social isolation, needs for more communication and unpreparedness for online teaching.Conclusion: Several factors were identified by participants about the additional support required from the university during COVID-19. Understanding and addressing these factors have the potential to improve student support during COVID-19 and support students in future crises.Impact statement: Understanding what support students perceive they require from the university during significant disruption will assist in future crisis management planning.

Effects of a Cognitive-Behavioral-Integrated Musical Rhythms Intervention on Anger: A Randomized, Single-Blind Factorial Trial

The current study aimed to determine the effects of a cognitive-behavioral-integrated musical rhythms intervention among nursing students at risk for experiencing anger. A randomized, single-blind factorial trial was conducted with 38 students who had above average trait anger scores. Group interventions were held over five sessions. Data were collected using pre-/posttest and follow-up measurements with the State-Trait Anger Expression Inventory and were analyzed using factorial analysis of variance. There were differences between groups in terms of trait anger (F[6, 68] = 22.64), anger control (F[6, 68] = 9.02), anger-out (F[6, 68] = 15.87), and anger-in (F[6, 68] = 10.89) (p < 0.05). Impact of the research was determined as strong/very strong in the time-group interaction. The newly developed intervention reduced students' tendencies to experience inappropriate expressions of anger more effectively and proved to have a stronger effect than other interventions. This intervention can be used to regulate nonpathological anger in adults and is recommended for researchers and practitioners who specialize in public mental health. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Perceived stress, stressors, and coping strategies among nursing students in the Middle East and North Africa: an overview of systematic reviews

BACKGROUND

In nursing students, high stress levels can lead to burnout, anxiety, and depression. Our objective is to characterize the epidemiology of perceived stress, stressors, and coping strategies among nursing students in the Middle East and North Africa region.

METHODS

We conducted an overview of systematic reviews. We systematically searched PubMed, Embase, PsycInfo, and grey literature sources between January 2008 and June 2020 with no language restrictions. We included any systematic review reporting measurable stress-related outcomes including stress prevalence, stressors, and stress coping strategies in nursing students residing in any of the 20 Middle East and North Africa countries. We also included additional primary studies identified through a hand search of the reference lists of relevant primary studies and systematic reviews.

RESULTS

Seven systematic reviews and 42 primary studies with data from Bahrain, Egypt, Iraq, Jordan, Oman, Pakistan, Palestine, Saudi Arabia, and Sudan were identified. Most studies included nursing students undergoing clinical training. The prevalence range of low, moderate, and high perceived stress among nursing students was 0.8-65%, 5.9-84.5%, and 6.7-99.2%, respectively. Differences related to gender, training period, or the type of tool used to measure stress remain unclear given the wide variability in the reported prevalence measures across all stress levels. Common clinical training stressors were assignments, workload, and patient care. Academic training-related stressors included lack of break/leisure time, low grades, exams, and course load. Nursing students utilized problem focused (dealing with the problem), emotion focused (regulating the emotion), and dysfunctional (venting the emotions) stress coping mechanisms to alleviate their stress.

CONCLUSIONS

Available data does not allow the exploration of links between stress levels, stressors, and coping strategies. Limited country-specific prevalence data prevents comparability between countries. Reducing the number or intensity of stressors through curriculum revision and improving students' coping response could contribute to the reduction of stress levels among students. Mentorship, counseling, and an environment conducive to clinical training are essential to minimize perceived stress, enhance learning, and productivity, and prevent burnout among nursing students.

Factors Affecting Resilience of Nursing, Optometry, Radiography and Medical Laboratory Science Students

Background: The concern over the high level of stress experienced by students of the caring professions has led to increased attention being paid to the promotion of their resilience. Most earlier studies have focused on the resilience of medical and nursing students. There has been little exploration of the resilience and associated factors of students of other health-care disciplines. The aim of this study was to gather data from students of pre-registration health-care disciplines to identify the factors that influence their resilience. Method: Valid questionnaires were used to assess respondents’ resilience, self-efficacy, mindfulness, coping and trait positive and negative affect. The data were analyzed using descriptive statistics and univariate and general linear regression. Results: A total of 1320 university students from nursing, medical laboratory science, radiography and optometry were recruited. The results showed that the subjects’ resilience scores were lower than those of students in Western countries. We found self-efficacy and denial to be the common predictors for students of all disciplines. Conclusion: The resilience of students in the four disciplines was predicted by a combination of predictors. Faculties of universities and clinical mentors should collaborate in building resilience in their health-care students and support them to grow both personally and professionally during their careers.

The influence of socio-demographic factors on stress and coping strategies among undergraduate nursing students

BACKGROUND

Nursing students may experience high levels of stress during academic study, which may affect their physical and mental health. Continued severe stress may lead to attrition from a program, particularly if utilised coping strategies are not appropriate or effective. In addition, some socio-demographic factors can influence an individual's perceived stress level and choice of coping strategies.

AIM

To determine if socio-demographic factors have an impact on perceived stress and preferred coping strategies of students enrolled in undergraduate nursing studies.

DESIGN

Descriptive correlational cross-sectional study design.

METHODS

Self-report questionnaires including a demographic questionnaire, Perceived Stress Scale, and Coping Strategy Inventory were utilised. A convenience cross-sectional sample of second- and third-year undergraduate nursing students (N = 377) were surveyed. Independent samples t-test, One-way ANOVA and multiple regression analysis were used to analyse data. Voluntary consent was obtained.

FINDINGS

A moderate of proportion of participants (60%) were International students. The majority (n = 270, 71.6%) of participants had moderate stress levels. Engagement coping strategies (M = 56.33, SD = 10.27) were preferred over disengagement coping strategies (M = 46.29, SD = 11.36) for managing stress. Independent associations were identified for 'gender', 'age', 'marital status', 'country of birth', 'residential status' and 'language spoken' with stress and utilisation of preferred coping strategies.

CONCLUSION

This study has determined that a significant number of students currently enrolled in an undergraduate nursing course may be experiencing a moderate amount of stress. Furthermore, participants' demographic factors may have influenced perceived stress and utilisation of coping strategies. Diversity in background may be contributing to additional stress for some students, who may have migrated alone, without family and support networks. Future research may evaluate strategies to reduce stress for undergraduate nursing students. Students for whom English was second language may require specific support to enhance their educational experience.

Psychological Well-Being in Nursing Students: A Multicentric, Cross-Sectional Study

In addition to complying with strict academic standards, nursing students must acquire relevant knowledge and skills, and learn how to carry themselves in different and often stressful professional settings. These obligations could severely affect their mental health. The purpose of this study was to examine the mental health status of undergraduate nursing students and related factors. A total of 1368 nursing students from different universities in Spain and Chile were included in this study, which took place over the 2018–2019 academic year. We assessed their levels of stress related to specific learning methodologies and determined their mental health status using the General Health Questionnaire (GHQ-28). The results revealed that the more advanced the course was, the lower the total GHQ-28 score. The stress generated by different types of training activities had a significant effect on the total GHQ-28 score. These results suggest that nursing education could act as a protective factor against mental health disorders. Although a heavy academic workload could lead to higher levels of stress, overall, it seems that mental health is better in more advanced courses than in initial academic years.

The visualization of stress in clinical training: A study of nursing students' perceptions

Aim

To determine the perceived level and types of stress experienced by nursing students during clinical training.

Design

A descriptive correlational cross-sectional design.

Methods

A convenience sample of 238 nursing students was recruited. Level and types of stress were measured by Perceived Stress Scale. The data were collected in February 2020.

Results

The mean score of perceived stress was 2.58 (SD 0.92). Different sources of stressors perceived by students were identified in current study. The highest type of stressors perceived by students was stress from taking care of patients (mean = 2.81, SD 1.13). In addition, junior students perceived higher level of stress than senior students and female students experienced a higher level of stress than male counterparts. Students who have been supervised by clinical instructors whom their "primary" language is English scored a higher level of stress.

Changes in stress levels and coping strategies among Finnish nursing students

Nursing students may face significant stress in their clinical learning environment and may use coping strategies to alleviate such stresses. However, little empirical evidence exists about the evolution of such stresses and coping strategies across study years. The aim of this study was to explore changes in stress levels and coping strategies among nursing students in clinical learning environment. Nursing students (N = 131) were followed during their first and second study year. Descriptive statistics and paired sample t-tests were used to measure changes in the variables within the same cohort. Nurse students perceived more stress in their second clinical practice compared to first one, with mean scores of 1.03 and 1.66, respectively. Stress from lack of professional knowledge and skills remained the main stress factor while transference was the main coping strategy across the two study years. Nursing educators should support nursing students to develop effective coping strategies from clinical stressors, especially from stressors such as lack of professional knowledge and skills and prepare their students mentally for clinical placement.

Profile of nursing students: quality of life, sleep and eating habits

OBJECTIVE

to profile and analyze sleep quality, quality of life and eating habits of nursing students.

METHODS

a cross-sectional, comparative and correlational study with the following variables: sociodemographic characteristics, Pittsburgh sleep quality index, quality of life and eating habits. One hundred ninety-five students participated in the study.

RESULTS

participants were on average 24 years old. Results showed that females were prevalent (87.1%); 71.0% of the students had poor sleep quality; 98.9% used electronic devices before bedtime. Self-perception of quality of life was indifferent (38.3%), and self-perception of general health, 36.9% expressed satisfaction. Among the participants, 45.13% consumed one portion of fruit and 40.66% two to three portions of vegetables daily.

CONCLUSION

the study allowed the profile of these students, sedentary, overweight and poor sleep quality young students who studied and worked.

Perceived Stress Among Iranian Nursing Students in a Clinical Learning Environment: A Cross-Sectional Study

BACKGROUND

Nursing students experience a high level of stress in clinical settings. This study aimed to investigate the stress perceived by Iranian nursing students in the clinical learning environment and its relationship with the characteristics of students.

METHODS

In this cross-sectional study, 430 nursing students who had passed at least 1 clinical training unit were recruited from universities in the Southeast of Iran using the census method. Data were collected by administering a demographic and researcher-made questionnaire to assess the perceived clinical stress. Demographic characteristics included age, sex, marital status, year of study, interest in the field, and previous semester average. Data were analyzed using independent t-test, ANOVA, and correlation coefficient test (α < 0.05).

RESULTS

The mean score of overall stress experienced by the participants was 92.08±16.8 (out of 160), which was at a moderate level. Based on the study results, the most stress-inducing factors for students were instructors' limited clinical competence and instructors' inappropriate conduct. Gender (p = 0.01), fathers' education (p = 0.01), mothers' education (p = 0.01), interest in the field (p = 0.01), and year of study (p = 0.01) had a significant effect on the mean score of perceived clinical stress.

CONCLUSION

The results of this study showed a moderate level of stress among the students. Also, instructors' limited clinical competence and inappropriate conduct were 2 factors that caused the highest perceived stress among nursing students more than other factors.

Stress in the Clinical Learning Environment: Perceptions of First-Year Finnish Nursing Students

AIM

The aim of the study was to examine how first-year Finnish nursing students perceive stress and the coping strategies they use in the clinical learning environment.

BACKGROUND

Stress from the clinical learning environment is a recurrent problem in nursing education. This topic has not been explored in the Finnish context.

METHOD

This is a cross-sectional study using data from 189 first-year nursing students. Students completed the Perceived Stress Scale and Coping Behavior Inventory; t-tests and Pearson correlation analyses were performed.

RESULTS

Our sample rarely experienced stress, with a mean stress score of 1.07 (SD = 0.49). A commonly reported stressor was lack of professional knowledge and skills (M = 1.49, SD = 0.82). Transference was the most common coping strategy.

CONCLUSION

Our findings may help nursing teachers understand stressors in the clinical learning environment and support their students to use effective coping strategies, such as problem-solving and optimistic attitudes.

Stress and Coping Strategies among Undergraduate Nursing Students: A Descriptive Assessment from Western Rajasthan

BACKGROUND

Nursing is a very challenging profession, which requires very stringent training since initial years of nursing education. Throughout the training period, students are exposed to various stressful situations. Inability to cope up with varied stressors may lead to psychological distress and impede students' pursuits of nursing career.

OBJECTIVES

The aim of the present study is to assess stress and coping strategies among nursing students of Western Rajasthan.

MATERIALS AND METHODS

Two hundred and twenty-one undergraduate nursing students were recruited for the study through total enumeration. Standardized Student Nurse Stress Index and brief cope scale were used to assess stress and coping strategies.

RESULTS

Nearly 82.4% of the students reported moderate level of stress. Interface worries (mean score 17.88 ± 4.9) and academic load (mean score 17.6 ± 4.78) were the major source of perceived stress. Students considered attitude of other professionals toward nursing, lack of free time, and fear of examination as most likely reasons of their distress. Active coping was the most commonly used coping strategies. Level of stress was found to have significant association with the interest of students in nursing.

CONCLUSIONS

Interface worries and academic-related concerns emerged as major source of stress. A positive trend was evident in the use of adaptive coping strategies over succumbing meekly. However, there is a great need to plan and implement stress management programs so that these budding health professionals could be better equipped and trained to face various challenges of the profession.

Nursing students' emotions evoked by the first contact with patient's body: A qualitative study

Providing personal care is one of the most significant activities of nursing care. Nursing students, who approach the patient's body for the first time, may experience a wide range of emotions, affecting their attitude toward the nursing profession and performance. Nevertheless, the emotional aspects related to providing personal care in nursing education have remained relatively neglected. A qualitative descriptive study was performed to describe the emotions felt by first-year nursing students when providing personal care and to analyze the situations which triggered their emotions. First-year students (N = 145) were asked to narrate episodes of body care evoking both positive and negative emotions. Emotions were analyzed according to Damasio's theory while trigger situations were inductively found through a content analysis. Our results show that first-year nursing students experienced mostly social emotions, with a significant triggering role played by patients. In most of the narratives, patients were seen as a source of (un)recognition and personal (un)satisfaction. In this pattern, the patients play a fundamental role in supporting their confidence. Providing emotional education and peer discussion/sharing may facilitate the ability of nursing students to become aware of their own feelings and to be focused on patient's needs.

Effectiveness of music therapy and progressive muscle relaxation in reducing stress before exams and improving academic performance in Nursing students: A randomized trial

BACKGROUND

Nursing students experiencing high stress levels before exams could suffer worse academic performance.

OBJECTIVE

We evaluated an intervention combining Progressive Muscle Relaxation (PMR) and music therapy on the decrease of before exams stress and the improvement of academic results.

DESIGN AND METHODS

Randomized controlled trial including students from the Nursing Degree during the first semester of the 2017-2018 academic year. All participants were randomized to the control (CG) or the experimental group (EG). The CG took the exam as usual whereas in the EG, PMR and music therapy were performed before exams. Blood samples were drawn to investigate variations in biochemical parameters. The academic performance was assessed by the score obtained in the "Clinical Nursing" exam.

RESULTS

We included 112 students (75% females, mean age 24.3 ± 6.2 years, 56 students in every group). There were no differences in any parameter during the first measurement. Regarding the second measurement, we observed a reduction in heart rate for the EG and an increase in blood pressure, heart rate, and cortisol for the CG. Indeed, these parameters were significantly higher compared to the EG. The EG had a mean score of 5.07 ± 1.59 in the Clinical Nursing exam, which was significantly higher compared to the CG (4.42 ± 1.58, p = 0.033). The proportion of fails in the CG was also higher (62.5% vs. 42.9%, p = 0.037).

CONCLUSION

In this study including students from the Nursing degree, the combination of PMR and music therapy was effective for the control and decrease of stress before exams, and also demonstrated improvements in academic results.

Preliminary psychometric properties of the Arabic version of Sheu and colleagues Perceived Stress Scale among nursing students at Jordanian universities

Purpose

Nursing is known to be a stressful profession, as it necessitates constant interaction with different individuals in an environment that is described as highly stressed. The stress phenomenon mainly affects the students of nursing more than other health-related students. The Perceived Stress Scale (PSS), which is developed by Sheu and colleagues represents the most implemented instrument to examine stress among nursing students that belong to different cultures in different countries. Previous studies have not fully examined the psychometric properties of the PSS, especially in the Arab World. Therefore, this study aims to assess the psychometric properties of the Arabic version of Sheu and colleagues Perceived Stress Scale (PSS), which is used to measure the clinical stress among nursing students.

Patients and methods

This methodological study utilized a cross-sectional design to test the PSS preliminary psychometric properties among 320 nursing students at 5 Jordanian universities.

Results

The Arabic version of the PSS showed high internal consistency reliability (Cronbach’s α was 0.90 in addition to an excellent content validity (CVI was 0.94). The exploratory factor analysis indicated that 54.54% of the total variance was accounted for by the five factors model, which confirmed the construct validity of the Arabic version of PSS. The findings of this study revealed that the Arabic version of PSS can be appropriately implemented among nursing students.

Conclusion

This study supports and recommends the use of the Arabic version of PSS to measure clinical stress among nursing students at Jordanian Universities.

Stress and Coping Among Nursing Students During Clinical Training: An Integrative Review

BACKGROUND

Nursing students perceive stress during clinical trainings and use various coping strategies to manage it. This integrative review critically appraises previous literature on stress and coping strategies among undergraduate nursing students during clinical training.

METHOD

An integrative review procedure was followed. Five electronic databases were searched with various search terms. A total of 1,170 publications were screened, 13 of which were included in the review.

RESULTS

Most studies applied a cross-sectional, descriptive approach. Students perceived moderate to high levels of stress during their clinical trainings, with problem solving and transference the most common coping techniques. Teachers and nursing staff were a strong stressor because students felt they were constantly being observed and evaluated.

CONCLUSION

The findings may provide guidance for how nursing staff can mentor students during clinical practice and establish a more supportive clinical environment. [J Nurs Educ. 2019;58(5):266-272.].

Providing Personal Care to Patients: the Role of Nursing Students' Emotional Labor

Background Providing personal care may be a source of emotional difficulties and negative feelings for students interacting with patients during their first clinical placement. This study was done to describe the role of emotional strategies for first year nursing students providing personal care to patients and the relationship of these strategies to students' emotional exhaustion, self-efficacy, and turnover intention. Method A self-reported questionnaire was administrated to a convenience sample of 226 first-year undergraduate nursing students attending their first clinical placement in one Italian University hospital. Results Results suggested a positive link between students' cognitive re-evaluation of their experiences and their self-perceived self-efficacy. Attentional deployment was the strongest antecedent of emotional exhaustion. Emotional dissonance was the primary contributor to students' turnover intention. Emotional exhaustion mediated the relationship between emotional dissonance and turnover intention. Conclusion This research suggested that there are emotional coping strategies useful for protecting student nurses from emotional exhaustion and turnover intention and that these strategies are positively related to students' self-perceived self-efficacy in providing personal care.

Asian American Women Sexual Assault Survivors' Choice of Coping Strategies: The Role of Post-Assault Cognitive Responses

Even though approximately one in three Asian American (AA) and Pacific Islander women experience sexual assault victimization, there is a dearth of literature examining how AA women sexual assault survivors cope with this traumatic experience. This study examined AA female sexual assault survivors' choice of coping strategies post-assault and how their cognitive responses toward sexual assault victimization (e.g., attributions of self-blame, perceived control over the recovery process) relate to their use of coping strategies. Using the AA subsets of two large community studies, a total of 64 AA women ages 18 to 58 with unwanted sexual experiences after the age of 14 years were included in the analyses. Results indicated that AA survivors used Acceptance and Self-Distraction the most to cope with sexual assault. In addition, those who perceived they had less control over their recovery process tended to use more maladaptive coping strategies, such as substance abuse and behavioral disengagement (e.g., giving up). Discussions include clinical implications and recommendations for using language, modalities, and foci of interventions that are consistent with clients' and their families' worldviews (e.g., indirect inquiries, solution-focused).

Coping and Pre-Licensure Registered Nursing Students: An Integrative Literature Review

Despite a wealth of information and growing diversity among nursing students, little is known about coping behaviors employed by these students or students educated in diverse environments. The aim of this integrative literature review was to examine what is known about stress, coping, measures of coping, and interventions to enhance coping, and in pre-licensure nursing students. Twenty-six peer-reviewed research articles were included. Stress, coping styles and behaviors, support, interventions, and instruments to measure coping were identified as key themes. Variations in coping were noted by gender, age, length of time in the program, and culture. Analysis of the literature illuminated the importance of support for students, and strong indications suggested educators play a pivotal role in helping students develop adaptive coping strategies. Nursing programs should consider incorporating coping instruction into the curricula.

A cross-country comparative study on stress and quality of life in nursing students

PURPOSE

This study was conducted to compare perceptions of stress and quality of life (QoL) among nursing students from three countries (the Philippines, Greece, and Nigeria) and to examine the impact of stress on their QoL.

DESIGN AND METHODS

A comparative, cross-sectional research design was used in this study. Data were collected from 547 nursing students from three countries using the perceived stress scale (PSS) and the quality of life evaluation skill (QOLES).

FINDINGS

Students' perceptions of stress and QoL were different across the three countries. Furthermore, higher stress perceptions were identified from taking care of patients, the clinical environment, and faculty, peer, and staff encounters, which predicted a negative QoL.

PRACTICE IMPLICATIONS

The findings emphasized the need for empirically tested and culturally tailored interventions to effectively reduce stress and enhance the QoL in nursing students.

Connections between academic burnout, resilience, and psychological well-being in nursing students: A longitudinal study

AIMS

The aim of this study was to explore the longitudinal associations between academic burnout and resilience and psychological well-being, and the stability of these variables in a sample of university nursing students.

BACKGROUND

Nursing students frequently suffer academic burnout, which is brought on by different situations experienced during the training process and that can concern his psychological well-being. Resilience is a personal resource that allows adverse situations to be handled in a successful way.

DESIGN

Longitudinal design.

METHODS

Data were collected at two moments separated by 18 months (2014-2016), with 218 students at T1 and 113 at T2. At each time a questionnaire was given to them, with questions about socioeconomic demographics and three validated scales to measure academic burnout, resilience, and psychological well-being.

RESULTS

The three dimensions that make up academic burnout remained steady over time, while resilience increased and psychological well-being improved. Hierarchical regression analyses revealed the longitudinal effect of emotional exhaustion at T1 and at T2 they showed the longitudinal effect of resilience on psychological well-being at T2. The inverse hierarchical regression analyses did not reveal significant relationships for any of the variables measured at T2 in connection with psychological well-being measured at T1.

CONCLUSIONS

Emotional exhaustion was the most relevant dimension of academic burnout when predicting psychological well-being in the analysed sample. Moreover, resilience has an important positive effect on psychological well-being in the analysed sample. The practical implications of the results are discussed from the perspective of academic training and some recommendations are given for future research in this field.

Stressors and coping strategies among physiotherapy students: Towards an integrated support structure

Background

Stress is a major problem among university and, specifically, health care students, as it may influence academic performance and psychological well-being negatively.

Aims

To develop and implement a student support system based on the perceived stress, stressors and coping strategies of physiotherapy students.

Methods

A cross-sectional, descriptive study was undertaken, using a literature-based, self-compiled questionnaire and the 28-item General Health Questionnaire (GHQ-28). Over a period of three years, 207 third- and fourth-year physiotherapy students at a South African university were included.

Results

Psychological distress was experienced by 61.8%-71.2% of participants. During the 3 months prior to the study, 6% of participants received psychological or psychiatric help and 9% of participants used some form of psychiatric medication. The main stressors identified during clinical training were the suffering and death of patients, academic pressure and tension during interaction with personnel. Participants indicated that they mainly coped with these stressors by talking to someone such as a family member or a friend.

Conclusions

Based on the findings of this study, a framework to identify and support students in pre-clinical and clinical training years was developed and implemented over five years. This proposed framework might positively contribute to the psychological well-being of health care students.

Examining stress perceptions and coping strategies among Saudi nursing students: A systematic review

OBJECTIVES

Stress is a perennial problem in nursing education and Saudi student nurses are not immune. Despite the growing literature examining stress in Saudi student nurses, a broader perspective on this concept has not been explored. This paper is a report of a review systematically appraising and synthesizing existing scientific articles reporting stress perceptions and coping styles in Saudi student nurses.

DESIGN

A systematic review method guided this review.

DATA SOURCES

Four (SCOPUS, CINAHL, PubMed, Ovid) bibliographic databases were searched to locate relevant articles.

REVIEW METHODS

An electronic database search was performed in August 2017 to locate studies published from 2010 onwards. The search words included: "stress" OR "psychological stress", "coping" OR "psychological adaptation", "Saudi Arabia", "student", and "nurse". Eleven (11) articles met the inclusion criteria.

RESULTS

Review of the findings showed moderate to high stress levels in Saudi student nurses that originated mainly from heavy workloads and taking care of patients. However, when the students' demographic characteristics were taken into account, inconclusive results were found, although some evidence showed higher stress levels in higher level students. Both active and passive coping styles were used by nursing students when dealing with stress.

CONCLUSIONS

Consistent with international studies, Saudi student nurses experience a considerable levels of stress from various sources. Findings may provide a direction for nursing faculty in formulating stress interventions that are empirically tested and culturally appropriate.

Nursing Students' Perceived Faculty Support, Stress, and Substance Misuse

BACKGROUND

Nursing school can be an extremely stressful experience. Many nurses with substance misuse issues developed the problem when they were students. The authors, guided by Peplau's interpersonal theory in nursing, examined whether stress and perceived faculty support were related to substance misuse.

METHOD

A quantitative, cross-sectional, correlational design was used. Data were collected from members of the National Student Nurses Association using an Internet questionnaire.

RESULTS

Students with higher stress scores had a higher incidence of substance use. Most students who had higher perceptions of faculty support tended to use fewer nonprescribed stimulants for academic enhancement.

CONCLUSION

Nursing students reported a moderate level of stress and used non-prescribed prescription drugs more frequently as the stress scores increased. Perceived faculty support was inversely related to the use of nonprescribed stimulants and does not appear to moderate the effects of stress on substance misuse. [J Nurs Educ. 2017;56(7):404-411.].

Stress and coping strategies among nursing students: an international study

BACKGROUND

Mounting literature on stress and coping in nursing students are available; however, most of the findings are confined to a single cultural group.

AIMS

This study was conducted to determine the level of stress, its sources and coping strategies among nursing students from three countries: Greece, the Philippines and Nigeria.

METHODS

Using a descriptive, comparative research design, 547 nursing students (161 Greek nursing students, 153 Filipino nursing students, 233 Nigerian nursing students) participated in the study from August 2015 to April 2016. Two standardized instruments were used, the Perceived Stress Scale (PSS) and the Coping Behavior Inventory (CBI).

RESULTS

Findings revealed that the degree of stress and the type of stressors and coping styles utilized by nursing students differ according to the country of origin. The year of study predicted overall stress (β = -0.149, p < 0.001) while advanced age predicted overall coping (β = 0.008, p = 0.037) in the nursing students.

CONCLUSIONS

Strengthening nursing students' positive coping skills may be helpful for them to effectively deal with various stressors during their educational experiences while maximizing learning. Implementing empirically tested approaches maybe useful to prevent the recurrence of stress and lessen its impact such as stress management counseling, counseling programs, establishing peer and family support systems, and formulating hospital policies that will support nursing students.

The Associations among Psychological Distress, Coping Style, and Health Habits in Japanese Nursing Students: A Cross-Sectional Study

Background: Nursing students in many countries have been reported to experience high levels of stress and psychological distress. Health habits could potentially mediate the association between coping styles and psychological status. The purpose of this study was to evaluate the mediation effect of health habits in the relationship between stress coping styles and psychological distress in Japanese nursing students. Methods: A total of 181 nursing students completed anonymous self-reported questionnaires comprised of the General Health Questionnaire-12 (GHQ-12), the Brief Coping Orientation questionnaire, and an additional questionnaire on health behavior. A mediation analysis using path analysis with bootstrapping was used for data analysis. Results: Multivariate linear regression analysis showed that psychological distress was significantly and positively associated with “Avoidance coping” (β = 0.39, p < 0.001), and was negatively associated with “Active coping” (β = −0.30, p < 0.001), “exercise habit” (β = −0.25, p = 0.001), and “sleeping” (β = −0.24, p = 0.002). In the path model, “Active coping” and “Avoidance coping” had significant or marginally significant associations with “exercise habits” (active: β = 0.19, p = 0.008, avoidance: β = −0.12, p = 0.088), and psychological distress (active: β = −0.25, p < 0.001, avoidance: β = 0.363, p < 0.001). However, these coping style variables did not have a significant association with “sleep”. In general, the size of the correlations was below 0.4. Conclusions: Exercise habits mediated the relationship between coping styles and psychological distress to a greater extent than sleep. The present study suggests the possibility that complex interactions between health habits and coping styles may influence the psychological status of nursing students.

The impact of a sense of self-efficacy on the level of stress and the ways of coping with difficult situations in Polish nursing students

INTRODUCTION

During their first practical classes at a clinical ward nursing students face a new environment; they take on new roles which is associated with stress and a need to handle it.

OBJECTIVE

The aim of this study was to evaluate the effect of a sense of self-efficacy on the level of stress and the ways of coping by Polish nursing students during the first practical classes at a clinical ward.

MATERIAL AND METHODS

The study included 394 undergraduate subjects studying nursing at two universities in Southern Poland. The study used the method of diagnostic questionnaire and estimation. The research tools included: an original questionnaire, Stress Scale (PSS10), Inventory to measure coping with stress (Mini Cope) and Generalized Self-efficacy Scale (GSES). Data analysis was performed using the IBM Statistical Package for Social Sciences, version 21 for Windows. The verification of differences between variables was performed using χ(2) independence test, Kruskal-Wallis test, and Spearman rank correlation coefficient. The level of significance was accepted at α=0.005.

RESULTS

The level of stress and a sense of self-efficacy in majority of tested nursing students were high. The people with low levels of perceived stress had a significantly higher sense of self-efficacy (rhoSpearman=-0.196; p=0.0001). The people with a higher sense of self-efficacy significantly more often used active strategies in stressful situations, such as Active coping (rhoSpearman=0.284; p<0.0001), Planning (rhoSpearman=0.318, p≤0.0001), Positive revaluation (rhoSpearman=0.228, p<0.0001), Acceptance (rhoSpearman=0.188; p=0.0002), Seeking Emotional Support (rhoSpearman=0.123; p=0.0143).

CONCLUSIONS

A sense of self-efficacy had a significant impact on the level of stress and the ways of coping with difficult situations in nursing students.

An exploratory study of the relationship between resilience, academic burnout and psychological health in nursing students

OBJECTIVES

The purpose of this study was to examine the relationship between resilience, academic burnout and psychological health in a sample of nursing students.

METHOD/DESIGN

A descriptive and cross-sectional design was applied, with questionnaires as tools.

PARTICIPANTS

The convenience sample consisted of 113 nursing students in their final academic year, who voluntarily participated in the study.

RESULTS

The results indicated a statistically significant relationship between resilience and both emotional exhaustion (r = -.55; p < .01) and psychological health (r = -.62; p < .01), as well as between all three dimensions of burnout and psychological health. Hierarchical multiple regression analysis indicated that high scores for resilience and low scores for emotional exhaustion predict better perceived psychological health [F_(2.96) = 17.75; p < .001].

CONCLUSIONS

Resilience was associated with lower levels of psychological discomfort and academic burnout. These findings highlight the importance of developing resilience and integrating it as an element in the nursing educational programme.

Psychometric Evaluation of the Spiritual Coping Strategies Scale Arabic Version for Saudi Nursing Students

AIM

To evaluate the psychometric properties of the Spiritual Coping Strategies scale Arabic version (SCS-A) in a sample of nursing students in Saudi Arabia.

METHOD

This study had a cross-sectional design with a convenience sample of 100 nursing students in Saudi Arabia. Using the SCS-A and the Muslim Religiosity Scale for data collection, data were analyzed to establish the reliability and validity of the SCS-A.

FINDINGS

Good internal consistency reliability (Cronbach's α > .70) and stability reliability (intraclass correlation coefficient > .80) were observed. Two dominant factors were extracted from the scale items, the nonreligious coping strategies and religious coping strategies, which accounted for 35.5% and 32.7% of the variance, respectively. The religious coping subscale exhibited a strong positive correlation with the religious practices subscale of the Muslim Religious Involvement Scale ( r = .45, p < .001) and total religiosity score ( r = .48, p < .001) as well as a weak positive correlation with the intrinsic religious beliefs subscale ( r = .25, p < .05). No significant relationship was found between nonreligious coping subscale and the Muslim Religious Involvement Scale.

CONCLUSION

The SCS-A exhibited an acceptable validity and reliability, supporting its sound psychometric properties with respect to the responses from Saudi nursing students.

Nursing students' perceived stress and coping behaviors in clinical training in Saudi Arabia

BACKGROUND

Clinical training has been recognized as a stressful experience for nursing students.

AIMS

The aims of this study were to identify levels and types of stressors among nursing students during their clinical training and their coping behaviors.

METHODS

Data were collected using a purposive sampling method from 100 nursing students using a self-reported questionnaire composed of Perceived Stress Scale and Coping Behavior Inventory.

RESULTS

Results showed that "assignments and workload" as well as "teachers and nursing staff" were the highest sources of stress in clinical training. The most common coping behaviors used were "problem-solving" and "staying optimistic". There was a significant difference in perceived stress among students in regard to the way of choosing nursing. There were significant differences in coping behaviors in regard to the presence of relatives in nursing, living status and mothers' educational level. The predictors of perceived stress were self-choosing for nursing and the presence of relatives in nursing, while the predictors for coping behaviors were stress from peers and daily life as well as mothers' educational level.

CONCLUSIONS

Nursing teachers and staff are encouraged to develop strategies that decrease level of stress and promote adaptive coping behaviors among nursing students during their clinical training.

Undergraduate student nurses' lived experiences of anxiety during their first clinical practicum: A phenomenological study

BACKGROUND

The Fundamental Nursing clinical practicum is an essential module for nursing students. Some feel stress or anxiety about attending this first placement; however, evidence demonstrates that it is rare to explore the feelings of anxiety felt by the nursing students concerning their first clinical practicum.

OBJECTIVE

This study was designed to explore student nurses' experiences of anxiety felt regarding their initial clinical practicum while studying for their University degree.

DESIGN

A phenomenological approach was used.

SETTINGS

A university in Southern Taiwan.

PARTICIPANTS

A purposive sampling of fifteen student nurses with anxiety reactions who had completed their first clinical practicum.

METHODS

Data were collected using a semi-structured guide and deep interview. Data were analyzed using Colaizzi's seven-step phenomenological method.

RESULTS

Three themes surfaced in the findings. The first theme was anxiety around their first clinical practicum, which stirred up anxiety about: self-doubt, worry and fear; difficulty coping with the learning process; worry hampered establishing therapeutic relationships with patients; the progress of the patients' illness could not be predicted; and anxiety felt about lecturer-student interactions. The second theme was three phases of anxiety reactions, which included increasing anxiety before clinical practicum; exacerbated anxiety during clinical practicum, and relief of anxiety after clinical practicum. The third theme was coping behaviors. This comprised: self-reflection in preparation for clinical practicum; finding ways to release emotions; distractions from the anxiety; and, also facing their difficulties head-on.

CONCLUSION

The findings could help raise the awareness of lecturers and students by understanding student nurses' anxiety experiences and facilitating a healthy preparation for their initial clinical practicum, consequently proactively helping reduce potential anxiety experiences.

Coping, stress, and personality in Spanish nursing students: A longitudinal study

The purpose of this study was to examine the dominant stress coping style in nursing students, its relationships with stressful life events and personality traits, and the students' changes during their academic training. A non-experimental two-wave longitudinal design was carried out in 199 nursing students recruited from three Spanish nursing schools. The Stressful Life Events Scale, NEO-FFI, and COPE questionnaire were administered at the beginning (T1) and end (T2) of their nursing studies. Descriptive statistics, Anova(s), NPar tests, and Pearson correlations were carried out. Results show that nursing students' dominant coping style was emotion-focused coping, both at T1 and T2. Highly significant correlations between emotional coping and the neuroticism trait were found. Coping, stress, and personality changed positively during the training program. At T2, the use of problem-focused strategies increased, and participants became more extroverted, agreeable, and conscientious. Coping and personality changes experienced by nursing students throughout their degree program seem to mirror the professional competences needed by future licensed nurses.

[Psychological distress in health sciences college students and its relationship with academic engagement]

OBJECTIVE

To determine the prevalence of psychological distress and its relationship with academic engagement (absorption, dedication and vigor), sex and degree among students from four public universities.

METHOD

A non-experimental,comparative correlational, quantitative investigation without intervention.

STUDY POPULATION

1840 nursing and physical therapy students. The data collection tool used was a questionnaire.

RESULTS

A 32.2% prevalence of psychological distress was found in the subjects; a correlation between vigor and psychological distress was found for all of the subjects and also for women. High absorption and dedication scores and low psychological distress scores predicted higher vigor scores.

CONCLUSION

The risk of psychological distress is high, especially for women. Women seem to have a higher level of psychological distress than men. Vigor, energy and mental resilience positively influence psychological distress and can be a vehicle for better results during the learning and studying process.

Influence of stress factors and socio-demographic characteristics on the sleep quality of nursing students

Objective:To analyze the influence of stress factors and socio-demographic characteristics on the sleep quality of nursing students. Method: An analytical cross-sectional and quantitative study, conducted with 151 nursing students in São Paulo between March and April of 2012. A form for socio-demographic characteristics, the Instrument to Evaluate Stress in Nursing Students and the Pittsburgh Sleep Index were applied. Results: High levels of stress was predominant for Time Management (27.8%) and Professional Training (30.5%) and low sleep quality (78.8%). The Professional Communication, Professional Training and Theoretical Activity are positively correlated to sleep quality. Work activity, academic year and time for daily studies contributed to a low quality of sleep. Conclusion: Few stress factors from the academic environment and some socio-demographic characteristics contributed to the reduction of sleep quality in students.